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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by llrrrpp on June 30, 2006, at 19:30:28
I've been napping like crazy, usually take a nap about an hour after waking up, a second nap in the mid morning, and an afternoon doze. short naps, perhaps an hour at the longest.
This despite getting 8 hours of sleep, rigidly adhering to a sleep schedule, and improvment in my depression.
I'm sick of overdosing on caffeine. I've been drinking or taking caffeine pills for up to 400 mg caffeine (though never after 2pm) and I still yawn and feel groggy all morning, afternoon& evening, but I also have anxious jitters and feel sick to my stomach too. I want to go to bed every night @ 8pm, but I force myself to stay up until 9-10 pm.
current meds 90 mg cymbalta & 25 mg of seroquel. I tried increasing seroquel to 50 mg. That was a disaster! I was only awake for about 10 hours on those days of the 50 mg seroquel experiment.
Cymbalta good for me. Felt positive mood, no more suicidal thoughts since I increased my dose 2 weeks ago. Don't want to stop this.
I think I want to try provigil, because I am sensitive to adrenergic peripheral effects. I don't want to take other kinds of stimulants, because I'm worried about my anxiety, which can ge out of control pretty easily.
How can I convince pdoc that I'm not a junkie looking for a study drug to make me a super-human?
Thanks for reading my long post,
-ll
Posted by Jost on June 30, 2006, at 20:57:11
In reply to how to convince pdoc that I want provigil, posted by llrrrpp on June 30, 2006, at 19:30:28
Convincing him that you want it: saying, "I really reallyreally really want provigil"--should work. (Sorry, I couldn't resist :)--)
Convincing him to give them to you-- well, the best approach depends on what type of person he is.
Your description of your energy level would be enough to convince many people-- It must be hard to function--and, even though there is some type of restriction on giving it, it's not the type of drug addicts generally go for.
Has he responded well to in the past to your ideas? Does he seem suspicious of people's motives?-- because there's nothing wrong with wanting to live a productive life--that's why you're using cymbalta, too.
Jost
Posted by llrrrpp on June 30, 2006, at 21:05:03
In reply to Re: how to convince pdoc that I want provigil, posted by Jost on June 30, 2006, at 20:57:11
> Has he responded well to in the past to your ideas? Does he seem suspicious of people's motives?-- because there's nothing wrong with wanting to live a productive life--that's why you're using cymbalta, too.
>
> JostThanks Jost,
In the past, he has told me to stick it out. Last time we adjusted the meds, he let me choose whether I wanted to increase the cymbalta from 60-90 mg. I said yes, and we did. He has also asked me what I expect to get out of the visit. One time I told him that I had a lot of anxiety. He said that the cymbalta should help with that, and that T should help with that even more. That T is doing the really heavy lifting. Meds just make T more effective.We'll see. I think throwing a llrrrpptantrum, (throwing myself prostrate on the floor, banging fists and such) would be quite memorable. What have I got to lose? I'm already diagnosed with a mental illness :) I'm not sure if it would be effective though.
Perhaps I'll just take a little nap on his couch in the middle of the appointment.zzzZZZzzzZZZ <grin>
-ll
Posted by Jost on June 30, 2006, at 21:58:17
In reply to Re: how to convince pdoc that I want provigil » Jost, posted by llrrrpp on June 30, 2006, at 21:05:03
Isn't it interesting that some pdocs are much more dubious about the value of pmeds than others.
It is hard to ask (or propose) in an effective way-- I'm the last person who should not understand that-- somehow I tend to "forget" until he's walking me to the door, at which point someone is waiting, so there isn't time.
Your pdoc really should consider this, IMO. Maybe he's conservative, certainly sounds like he isn't into combining meds. But you might need a more adventurous person.
My pdoc, whom I respect and like, is really open to many options, and trying to make things as good as possible-- without hesitations-- if there's a likelihood it would work--
Esp. since these meds are far from perfect, and even if they work, the side-effects can force you to stop. T is important, but, for me, ADs and provigil (or even stronger things, on occasion, although I don't tend to use them) have made a huge difference, without which I doubt T would be particularly useful. And T can take years-- why should you lose that time?
Not that he may not be the right or best person, but would you consider seeing someone else?
Jost
Posted by llrrrpp on June 30, 2006, at 22:18:12
In reply to Re: how to convince pdoc that I want provigil, posted by Jost on June 30, 2006, at 21:58:17
Actually Jost,
I hold my pdoc in great regard, as a human being and as a doctor. I think he is very well respected in his field. That may be why I am reluctant to ask for more.Also I am generally reluctant to ask for help. Also I am worried that taking psych meds makes me a weak person and only a tiny step above a street junkie (Really no offense intended- I only apply this reasoning to myself. For a long time I thought I could "will" myself out of my misery. yeah. well, it didn't work out that way. I might not have a strong will; or I might be ill beyond a point where "will" can make me well)
He was very quick to give me seroquel samples when I complained of unrelenting insomnia a while back, and let me tinker with my dosage on that one. So, I may be making a mountain out of a molehill here. I guess I should just take a deep breath, and ask him. The worst he can say is "no... I don't think it would be a good idea for you [and then explain his reasoning]" I will probably have more regrets about *not* asking him, compared to the discomfort I will feel when admitting- hey, pdoc, I've got a little problem *yawn* I can't stay awake anymore, but when I don't take seroquel I can't sleep, and when I DO take it, I sleep all the time. *yawn* And I've been OD'ing on caffeine and I feel like crap. Is there anything better?
I think I'll practice in the mirror first. Thanks for letting me practice here.
yours,
-ll
Posted by Phillipa on June 30, 2006, at 23:13:44
In reply to Re: how to convince pdoc that I want provigil » Jost, posted by llrrrpp on June 30, 2006, at 22:18:12
Sounds like a winner!!!!!Love Phillipa
Posted by Dinah on July 2, 2006, at 16:41:52
In reply to how to convince pdoc that I want provigil, posted by llrrrpp on June 30, 2006, at 19:30:28
Can you consult a sleep specialist for a study? My sleep neurologist is convinced I have mild narcolepsy, although the sleep study didn't seem to support that diagnosis, and he practically forced Provigil on me.
I can't function without my twice a day Provigil anymore. I'm not thrilled about that.
Posted by llrrrpp on July 2, 2006, at 17:05:33
In reply to Re: how to convince pdoc that I want provigil » llrrrpp, posted by Dinah on July 2, 2006, at 16:41:52
Hi Dinah,
Good idea, especially since both my parents have history of sleeping disorders Dad= central sleep apnea Mom=obstructive sleep apnea+narcolepsyMy husband doesn't report me snoring or gasping. I've never had a problem sleeping before I developed depression. Even when I was only sleeping for 4-5 hours a night this spring, I didn't have excessive daytime sleepiness, and I wasn't abusing caffeine either.
> Can you consult a sleep specialist for a study? My sleep neurologist is convinced I have mild narcolepsy, although the sleep study didn't seem to support that diagnosis, and he practically forced Provigil on me.
>
> I can't function without my twice a day Provigil anymore. I'm not thrilled about that.Yes, I'm concerned about this possibility also, however, I cannot get out of my pajamas without at least 200 mg caffeine, and I can't much function now either, regardless of caffeine dose. I'm already dependent on caffeine which isn't working for me, and the sleepiness seems coincident with my dose increase on cymbalta.
thanks for your suggestion- I'll see what happens with pdoc this week.
-ll
Posted by llrrrpp on July 3, 2006, at 12:00:50
In reply to Re: how to convince pdoc that I want provigil » Dinah, posted by llrrrpp on July 2, 2006, at 17:05:33
i described my sleepiness, and he suggested 200mg provigil, once daily. I didn't even have to suggest it. And i got samples.
lucky me. i just took the first dose a few minutes ago.
Thanks for all your kind suggestions.
If a stranger raided my medicine chest right now they'd think I was a psychotic narcoleptic with periperhal neuropathy. haha
Posted by Dinah on July 5, 2006, at 19:46:50
In reply to pdoc gave me provigil :) » llrrrpp, posted by llrrrpp on July 3, 2006, at 12:00:50
Good for you. :)
Doctors don't seem to have a problem with Provigil.
This is the end of the thread.
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